Lutheran Sunset Home Corporation
Organization Active NPI Custodial Care Facility · Grafton, ND
NPI 1194197459 · NPPES record last updated Oct 27, 2015
Key facts
- NPI
- 1194197459
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Custodial Care Facility 311Z00000X
- License
- 8108 (ND)
- Legal business name
- LUTHERAN SUNSET HOME CORPORATION
- Practice address
- 333 Eastern Ave
Grafton, ND 58237-1233 - Phone
- (701) 352-1901
- Fax
- (701) 352-1926
- NPI assigned
- Oct 27, 2015
- Organization subpart
- No
Authorized official
- Name
- Mr. Jason Carlson
- Title
- Ceo
- Phone
- (701) 352-1901
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Lutheran Sunset Home
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Custodial Care Facility | 311Z00000X | 8108 | ND | Yes |
Addresses
Primary practice location
333 Eastern Ave
Grafton, ND 58237-1233
Mailing address
333 Eastern Ave
Grafton, ND 58237-1233
Phone (701) 352-1901
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1458265 | Medicaid | ND | |
| 1636 | Other | ND | BC/BS |
Other providers in Grafton, ND
- Karissa Lindseth
- Summer Linke
- Natalie Lee Lopez
- Averi Ashton Lundebrek
- Lutheran Sunset Home Corporation
- Kimball Anthony Lutovsky
- Heidi Jo Madsen
- Ashley Mathiason
- Jaime Rae Mattson
- Samuel Mihari Mburu
All providers in Grafton, ND · Custodial Care Facility in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.